Amalgam Restoration I Notes: - the mid-term practical exam is out of 15 (10 marks for cavity preparation and 5 marks

for amalgam restoration) - The mid-term theoretical exam is out of 15 (online exam, not written) - The mid-term theoretical exam will include 6 lectures: 1- introduction lecture 2- instrumentation 3- principle of cavity preparation I 4- principle of cavity preparation II 5- amalgam restoration I (today’s lecture) 6- amalgam restoration II (next lecture) This lecture is divided into two parts: First part: about classification of dental amalgam and some properties related to the uses of amalgam. Second part: will be about the principles of cavity preparation related to amalgam that we have taken in the labs, so this part is repetition ,but we should remember it to be included in the theoretical exam, and we will be asked about them First part: Amalgam = Tin-silver amalgam alloy+ mercury So Tin-silver alloy mixed with mercury to form dental amalgam, we use the amalgamator to mix them together. Previously, the process of mixing was made manually, where there is to bottle one contain powder (the alloy), and the other contain the mercury, they mix them together to get dental amalgam, but the disadvantage was the spilling of mercury which is a heavy metal. Now we use capsules, so we don’t touch the mercury at all, these capsules contain mercury and alloy separated by a sheet, to get the amalgam we put a capsule in the amalgamator, this sheet will broken so the mercury mixed with the alloy to form dental amalgam.

Classification of dental amalgam:

lathe-cut alloy 2. Spherical Vs Lathe-cut: ● Spherical alloy particles require less condensation pressure than lathe-cut fillings. copper. tin. 2. So all the physical properties is improved with increase the amount of copper in the alloy. Particle size and shape: 1.High copper alloy 12-30% by weight.All what we use mow in the clinic is high copper alloy. Why? Bcz the irregular shape of the particles in lathe-cut require more pressure during condensation to condense the particles together.spherical 3.Conventional amalgam alloy (low copper alloy) 2. so it has properties intermediate btw the two.High copper alloy Or according to particle size and shape into: 1. marginal breakdown.Spherical alloy: balls in shape. . bcz all the physical properties increase as the copper contents increase.admixed Copper content: . . Conventional Vs High Copper Amalgam Alloy: High copper amalgam alloy have superior resistance to discoloration. zinc. 3. and creep compared to conventional amalgam.Admixed: mixture of the two. while .Dental amalgam can be classified according to copper content into: 1. so as the shape is .lathe-cut alloy: during the processing of the amalgam they shape it in different shapes one of them lathe-cut alloy which has sharp angles and irregular shape.The amalgam alloy consists of silver.The conventional alloy contain 0-6% by weight. corrosion.

2. bcz the setting time affects the working time.strong: here we talk about direct restoration (direct restorations: which we use directly in the clinic e. 4. 5. but if we have cusp building or MOD we have to use the one with longer working time to be able to condense and carve it. if you press from one side the balls will escape to the other side. inlay. No material what ever this material can fill this gap.Relatively easy to use. ●spherical high copper amalgam is the fastest in setting. And also what ever . so if we have small cavity like class I we can use the one with short working time.Marginal sealing with time: amalgam is the only material that cause marginal sealing with time. 3. ● so we need larger size condenser with the spherical alloy.irregular this means that we need more pressure during condensation to bring them together.g. amalgam.g. The same for the spherical if you press (condense) it. so amalgam relatively to other direct restoration is the strongest. comparing to lathe-cut alloy which has irregular particles (it is better to get less mercury) ● spherical alloy require greater care in condensation than admixed or lathecut alloy to obtain good adaptation and tight contact. onlay. crown). ● spherical alloy particles have less mercury content since less mercury is needed to coat the particles during amalgamation (amalgam mixing).Durable: last for long period of time. You should know that always there is a gap btw the restorative material and the tooth structure. we call this gap “micro-gap”. It is important to know which has faster setting time. Advantages of amalgam: 1. so the spherical alloy requires care in condensation to get good contact. composite. GIC… indirect restorations: the one which need impression and lab e. the particles will escape up and to the margins. Imagine that the spherical alloy as a room full with balls.Low-technique sensitivity.

it can be useful here). This is beyond you . what happen if we do a restoration to the opposing tooth? The rate will differ bcz the relation become toothrestoration. But if this restoration is amalgam the rat will be similar to that if we have do in adaptation to fill this gap it will remain. But the only material that will seal with time is amalgam.susceptible to corrosion and galvanism 3. we cant use it for anterior teeth bcz it isn’t teeth colored. Now if two teeth come in contact for long period of time they will take from each other in the same amount bcz they are the same material. II.not tooth colored (silver in color) 2. 2.Base build-up prior to crown preparation. where the corrosion results will seal this micro-gap with time. If we compare it with porcelain.g. So this is an advantage to amalgam. (Although this process considered as a disadvantage. V ) restoration in posterior teeth. (E. class I. porcelain will wear the opposing tooth structure more. 1. 7-Wears at rate similar to that to of tooth structure: wearing: is the deterioration or loss of tooth structure as a result of contact with a other thing.contain mercury Indications: Where we use amalgam. . 6-Antibacterial properties: the bacterial growth is less near amalgam. 8-Least time consuming and has the lowest cost.does not bond to tooth structure 4. so we need to build up this tooth first (bcz we don’t make crown on a broken tooth) using amalgam. Disadvantages of amalgam: 1.we use it in stress bearing area. then we do the crown.but this when we have a broken tooth and we need to crown this tooth. This sealing occur bcz of a process called “corrosion” to amalgam.

We have initial set: this is when the working time finish. after that we cant work with it any more. increased condensation forces & the use of smaller particles alloy. . but initially this gap is found) 2. But in composite sometime I leave it bcz composite bind to tooth structure so it is strengthen these undermined enamel. But the final set actually after that bcz still there is a dimensional changes occur (expansion & contraction) 3.We said that there is a micro-gap btw amalgam and restorative material that cause microleakage. retention grooves… ● setting dimensional changes: 1.most of this dimensional changes occur in the first 6 to 8 hours after mixing. excess mercury & moisture contamination. And still we need to make the mechanical retention features such as convergent wall. 3.factors that contribute to expansion are: undermixing. as more tooth structure is lost the possibility of fracture increases. 4. As minimum as possible. bcz there is a possibility later on to fracture in this undermined enamel. ● Amalgam bonding: There is attempts have been made to bond amalgam with adhesive resin liners (means make amalgam like composite ) Some of the studies found good result n increase retention and strength of amalgam but most of them are laboratory studies. In comparison to composite it strengthen the remaining tooth structure bcz it binds to tooth structure.amalgam does not strengthen the remaining tooth structure. but the sealing occur with time in case of amalgam.condensation of amalgam in the cavity should be done efficiently and promptly to minimize this micro-gap. (this is in any material. if we have undermined enamel we should remove it with amalgam restoration.Properties: ● Adaptation: 1.factors contribute to contraction are: overmixing.there is a number of dimensional changes during setting of amalgam (expansion & contraction) 2. According to that.

3-all margins should be90 to minimize marginal fracture .so amalgam should have sufficient bulk to compensate for this weakness.the low copper lathe-cut amalgam is the slowest in setting.decrease strength will result from undermixing or contamination during placement ● setting speed: 1.which is the cavosurface margins of amalgam to give enough thickness at the margins so prevent fracture of the amalgam at the margins.) 5.Removal of excess mercury during condensation ( by the way if we do good condensation all the excess mercury comes to the surface and then removed by burnishing the amalgam) b. 4-Factors that contribute to increased strength of the amalgam is: a.5 mm thickness by making the depth of the cavity 1.5mm.Amalgam tensile strength (tensile force when we tense two thing from each other) is lower than its compressive strength (compressive force is the force on the long axis of the tooth) so the fracture of amalgam occurs due to tensile forces.the fastest setting time is the high-copper spherical.5-high copper amalgam have less setting dimensional change than conventional amalgam.increase condensation force to eliminate voids (if we have voids in the amalgam this means the thickness of the amalgam is less that affect the strength of the amalgam. 2-the high copper admixture & the low copper spherical have intermediate setting time (but we don’t use the low copper alloy any more) 3. (remember. Sufficient bulk obtained by 1. 2. all the properties is better for high copper amalgam than low copper (conventional) ● Strength: 1. high bcz we don’t use low any more) . (if we have large cavity it is better to choose high copper lath-cut amalgam.

incorrect mixing time and .fast-set: usually it is high copper spherical . 4. ● Creep: It is deformation due cyclic load( force). 3.increasing mercury . 3-and if proceeds it can weaken & cause fracture to the amalgam.The permanent deformation of set amalgam when it is subjected to mild. As you know the forces inside the patina’s mouth is cyclic ( repeated for long period of time) 1. 2-it isn’t good bcz initially can result in pitting and discoloration of the surface of amalgam. .high copper amalgam alloy have lower creep than conventional amalgam alloy.decreased condensation to a greater degree than is the creep of high copper advantage of amalgam corrosion is the filling of the marginal gap with the corrosion products. continuous or cyclic forces. The more setting time speed the less the working time.4-the working time is related to the setting speed. ● Corrosion: 1-it is the slow deterioration of amalgam in the oral environment.regular-set: it is admixed high copper .slow-set: it is high copper lathe-cut 6-alloy should be selected that has appropriate working time. So these margins may subjected to break to produce open restoration.manufacturer’s classification: .creep of conventional amalgam is influenced by .can result in marginal or proximal extrusion of amalgam restorations. 5. 2. 4.

By this we finished the first part of the lecture Second part: Cavity preparation for amalgam: ●Outline form: 1.The cavosurface margins on the proximal surface should not touch the adjacent teeth or restorations from all direction bucaal.the pulpal &axial walls should be in dentin. It is difficult to condense . 5-All cavosurface angles (the angle btw the prepared and the unprepared tooth surface) should be approximately 90◦ .the pulpal floor should be flat & smooth. lingual & gingival. 3. 4-The opposing walls of the cavity preparation should be parallel or slightly convergent toward the surface of the tooth. The axial walls should be convex &follow the contour of the surface of the tooth. And the cavity should be box in shape with 1. While in composite it is more than 90◦ .the cavosurface outline should be continuous the thickness of amalgam at the margins should be good enough to prevent fracture of the amalgam at the margins.carve & burnish amalgam in to sharp angles. 3. 2. removing only carious & potential carious pit & grooves.5-two types of corrosion chemical and electrochemical.Cavity depth and width should be enough to create sufficient bulk to the restoration. especially on occlusal surface. line.5 mm depth and should be in the DEJ 2. ●Resistance form: 1.The outline should be kept as conservative in width as possible(and as small as possible).

In proximal lesions.we made it round. Class I with buccal pit amalgam: ●Outline: When we did the buccal pit in the lab . bcz we assumed that the carious was round shape. In large preparation. 3.5mm width 2. -Finishing the enamel . with 1 mm width and 1.triangular outline so we should make a cavity triangular with 1.sufficient retention is obtained by resistance form.●Retention form: 1.If the caries was rounded we will carve in round shape. 2.mesial and distal walls are parallel or slightly divergent toward buccal wall . But we have different shapes of the caries in this area: 1. the access should whenever possible avoid extension beyond what is necessarily to access the proximal lesion &the adequate retention form. -Removal of carious dentin. auxiliary retention features can be added. ● resistance form: 1.(as we did in the lab) So the outline reflects the caries.Retention grooves are routinely placed in the buccal and lingual proximal walls of class II preparation.5mm depth.wide enough for instrumentation of the cavity & condensation of amalgam.if the caries extended more all over the fissure we call it capsular outline.If occlusal lesion is present it should be treated separately whenever possible. -Cleaning the cavity. 2. ●Convenience form: 1. 3. and all the enamel margins should be 90.

the axial wall depth is 1. no need for additional retention.5-2 mm 4. When we have 2 separate occlusal cavities . 2. central. buccal.All faciolingual width should be 1.5-2 mm expect at the intersection of grooves. 3. We make it by small round bur and pass it in the pulpoaxial line angle.mandibular first premolars .in large size preparations.5mm or just inside the DEJ 4-the axial wall follow the external contour of the buccal surface of the tooth. lingual grooves. Class I occlusal amalgam: ●outline form: 1.if there is undermined enamel under the oblique ridge 2.if we remove a lot of the oblique ridge that the remaining part of it only 0. ●resistance & retention forms: 1. retention grooves can placed in these two situation we should remove the oblique ridge and make one restoration.5mm . But actually there is two situation where we remove it: 1. 2.Free flowing outline form with no sharp corners. 3. distal or gingival walls. ● retention form: 1.we should treat them separately such as: . we did 2 cavities separately bcz the presence of the oblique ridge .B & L walls are parallel or slightly convergent occlusally. .include mesial and distal pits.pulpal floor should be at right angle to the long axis of the tooth. 2.Pulpal depth ideal size buccal pit.maxillary molars If you remember what we did in the lab on lower 6.occlusal & gingival walls are parallel or slightly divergent toward the buccal surface.Except of the mabdibular first premolar (angled lingually) 3.

from gingival to pulpoaxial line angle.25 mm ●resistance & retention form: 1.Pulpal depth :1. Distal wall is vertical 3.B & L walls are parallel or slightly convergent 3.same as class I 2.mesial: central pit.Depth puloully: 1. ½ of buccal groove.B & L walls :parallel or slightly convergent 2.M & D walls: on occlusal diverge occlusaly. The End Done by: Alaa Al-sarhan .Axiall depth :1.(shouldn’t de undermined with enamel) Class I with buccal extension: ●outline: 1.pulpal floor should be at right angle to the long axis of the tooth.25 -2 mm ●resistance & retention form: 1. 2. mesial pi.Depth axially: 1.5.Distal: “ L” shaped preparation.Retention grooves: grooves in M & D walls Class I with lingual extension: ●outline: 1.5-2 mm 4.5-2 mm 4. In M. D walls . 3.M & D walls diverge occlusaly.M & D walls: mesial diverges.M & D walls of the extension: parallel 4. 2. Those on facial extension are parallel 4.B groove is extended to include buccal pit 3. include distal pit and lingual grove.Retention grooves in the lingual box.

Sign up to vote on this title
UsefulNot useful